title: Cardiovascular autonomic dysfunction is associated with central obesity in persons with impaired glucose tolerance.
abstract: OBJECTIVE
  The aim of this study was to investigate the prevalence of cardiovascular autonomic neuropathy in persons with previously diagnosed impaired glucose tolerance and to characterize associations between components of metabolic syndrome and cardiovascular autonomic neuropathy in the Finnish Diabetes Prevention Study cohort.
  
  
  METHODS
  Two hundred and sixty-eight individuals with impaired glucose tolerance at baseline in the Finnish Diabetes Prevention Study, but not diagnosed with diabetes during follow-up, were studied for cardiovascular autonomic neuropathy. At the second annual follow-up visit after the end of lifestyle intervention, we performed deep-breathing and active orthostatic tests to detect possible parasympathetic and sympathetic dysfunction. To describe metabolic characteristics, anthropometric measurements, an oral glucose tolerance test and assessments for HbA(1c,) serum lipids and blood pressure were carried out.
  
  
  RESULTS
  Prevalence of parasympathetic dysfunction was 25% and prevalence of sympathetic dysfunction was 6%, with no difference between the former intervention and control group participants or between men and women. Subjects with parasympathetic dysfunction were older, more obese (weight, waist circumference, body mass index) and had higher triglyceride concentration compared with those with normal parasympathetic function (P<0.01 for all). Parasympathetic dysfunction was not significantly associated with other characteristics of metabolic syndrome; for example, high cholesterol, glucose and insulin levels or HbA(1c) . Correlations between the Expiration/Inspiration (E/I) ratio (the longest heart beat duration in expiration divided by the shortest heart beat duration in inspiration) and measures reflecting obesity were statistically significant in the pooled population and in men but not in women.
  
  
  CONCLUSIONS
  Cardiovascular autonomic neuropathy is common in persons with impaired glucose tolerance. Obesity, especially among men, seems to play an important role in the early pathogenesis of cardiovascular autonomic neuropathy.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Puijonlaaksontie2, Kuopio, Finland.Tomi.Laitinen@kuh.fi
authors.forename: T
authors.initials: T
authors.lastname: Laitinen
authors.forename: J
authors.initials: J
authors.lastname: Lindström
authors.forename: J
authors.initials: J
authors.lastname: Eriksson
authors.forename: P
authors.initials: P
authors.lastname: Ilanne-Parikka
authors.forename: S
authors.initials: S
authors.lastname: Aunola
authors.forename: S
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: M
authors.initials: M
authors.lastname: Uusitupa
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D018149:Glucose Intolerance / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human